Robert Max Dyksterhouse, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

253101 Issued in NY

Practice address

4940 W Clark Rd Ste 100
Ypsilanti, MI 48197-0860

Phone

(734) 971-1188

Fax

(734) 971-3658

NPI assigned

Jun 5, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Chelsea Hospital Hospital, Chelsea, MI, CCN 230259

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rdyksterhouse3101224@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568841930
  Medicare reassignment NPD
• Iha Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Family Medicine Physician
  • Ypsilanti, MI
  • NPI 1699822742
  NPD
• Icahn School of Medicine at Mount Sinai

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Iha Health Services Corporation

  • Family Medicine Physician
  • Milan, MI
  • NPI 1467509067
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Chelsea Inc

  • General Acute Care Hospital
  • Chelsea, MI
  • NPI 1992761985
  Care Compare affiliation
• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1780810697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR # J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 W CLARK RD STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481970860",
            "telephone_number": "734-971-1188",
            "fax_number": "734-971-3658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "226 W 14th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100117201",
            "country_code": "US",
            "telephone_number": "212-604-1800",
            "fax_number": "212-604-1829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKSTERHOUSE",
        "first_name": "ROBERT",
        "middle_name": "MAX",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301510567",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "253101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice M Durham, RN
• Swati Dutta, MD
• Xin Dwyer
• Kayla Selena Dye
• Alyshia Marie-Sandra Dyer, LLMSW
• Safiya Francesca Dzotsi
• Ellen Gray East, MD
• Kalee Easter, AU.D.
• Lauren Noelle Easterbrook, CRNA
• Eastern Michigan Pharmacy Inc

• Internal Medicine Physician in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.